An excellent article published April 13, 2020, about a New York Times forum ‘highlighting the moral implications of suppressing economic activity,’ by Jacob Sullum, a Senior Editor at Reason
The title of the forum was “Restarting America Means People Will Die. So When Do We Do It?”–quite a loaded premise for discussion.
Jon Allsop, who writes the Columbia Journalism Review‘s daily newsletter, argues that the conversation about when and how to relax COVID-19 lockdowns is a “false debate” that misleadingly pits “lives” against “livelihoods.” In reality, Allsop says, there is “no choice to be made between public health and a healthy economy—because public health is an essential prerequisite of a healthy economy.”
In this article, Princeton bioethicist Peter Singer is particularly cogent in his views.
Singer forthrightly questions “the assumption…that we have to do everything to reduce the number of deaths.” That assumption is manifestly wrong, as reflected in the decisions that government agencies make when they assess the cost-effectiveness of health and safety regulations—decisions that routinely take into account not just the deaths that might be prevented but the resources expended to do so. Those assessments assign a large value to preventable deaths, but the value is not and cannot be infinite.
“At some point,” Singer says, “we are willing to trade off loss of life against loss of quality of life. No government puts every dollar it spends into saving lives. And we can’t really keep everything locked down until there won’t be any more deaths. So I think that’s something that needs to come into this discussion. How do we assess the overall cost to everybody in terms of loss of quality of life [and] loss of well-being as well as the fact that lives are being lost?”
Singer is equally frank in discussing the weight that should be assigned to COVID-19 deaths, whether they are prevented by current control measures or allowed by loosening those restrictions:
This is killing mostly older people. I think that’s really relevant. I think we want to take into account the number of life years lost—not just the number of lives lost.
The average age of death from COVID in Italy is 79½. So you do have to ask the question: How many years of life were lost? Especially when you consider that many of the people who have died had underlying medical conditions. The economist Paul Frijters roughly estimates that Italians lost perhaps an average of three years of life. And that’s very different from a younger person losing 40 years of life or 60 years of life.
Singer emphasizes that the economic cost of aggressive control measures is morally important and not simply a matter of elevating crass financial concerns above issues of life and death.
If we’re thinking of a year to 18 months [the projected amount of time required to develop and deploy a vaccine] of this kind of lockdown, then we really do need to think about the consequences other than in terms of deaths from COVID-19. I think the consequences are horrific, in terms of unemployment in particular, which has been shown to have a very serious effect on well-being, and particularly for poorer people. Are we really going to be able to continue an assistance package to all of those people for 18 months?
…”Yes, people will die if we open up, but the consequences of not opening up are so severe that maybe we’ve got to do it anyway.” If we keep it locked down, then more younger people are going to die because they’re basically not going to get enough to eat or other basics.
We need to think about this in the context of the well-being of the community as a whole….We are currently impoverishing the economy, which means we are reducing our capacity in the long term to provide exactly those things that people are talking about that we need—better health care services, better social-security arrangements to make sure that people aren’t in poverty.